Diabetes disclosure strategies in adolescents and young adult with type 1 diabetes.
Andrea K Pihlaskari, Barbara J Anderson, Sahar S Eshtehardi and 4 others
PMID 31447195WHAT IT FOUND
Young people with type 1 diabetes described three ways of telling others: openly explaining for safety and support, hiding or avoiding because of discomfort and burden, or letting diabetes become known through parents, supplies, or routines.
Strategies varied by situation and trust.
Key findings
01Three disclosure strategies emerged: Open Disclosure, Disclosure Hesitancy, and Passive Disclosure.
02Open Disclosure was used to educate others and prepare them for urgent diabetes situations.
03Hesitancy involved hiding or avoiding diabetes talk, while passive disclosure meant others learned about diabetes without the participant directly telling them.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a secondary analysis of interviews not designed to study disclosure, so disclosure topics arose within broader quality-of-life questions rather than through targeted questions. The sample was small and geographically specific: 16 adolescents and young adults from two academic medical centers in the United States, so themes may not apply to other ages, cultures, or care settings. The researchers could not compare disclosure strategies between adolescents and young adults because the sample was too small. No outcome data were collected or tested, so the study cannot show that any disclosure strategy improved safety, social support, mental health, or diabetes management. The study did not examine how recipients reacted to disclosure, so it cannot say whether disclosure led to helpful or stigmatizing responses. Researchers did not bracket their prior assumptions, and the initial codebook was influenced by clinical experience and literature from other populations.
Declared interests
No conflict-of-interest statement is included in the supplied article text. The supplied publication types indicate NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that open disclosure improves safety, social support, or mental health. This qualitative study described disclosure strategies in 16 adolescents and young adults with type 1 diabetes and did not test disclosure, measure outcomes, or compare the strategies. Participants also hid or disclosed passively depending on context.